If you didn’t see the story, here’s a recap. The Department of Veterans Affairs’ Office of Inspector General revealed a “potential pattern of excessive fluid adminstration in SICU patients.” Its report focused on three patients who died in 2005 or 2006, after being bloated with IV fluids. Two veterans gained 100 pounds before they died; another, a female, gained 89 pounds prior to her death.

The article on Sunday told the story of Jose Lara, one of the three patients, and his family’s quest to hold the VA and its doctors accountable. Lara’s son, Danny, a registered nurse who works at a private facility, and an unidentified complainant, possibly a VA staff member, came forward with concerns that resulted in the OIG’s investigation. The report, released Dec. 17, cited problems with documentation and leadership, and outlined a six-part action plan that’s been implemented since April to address issues in the SICU.

One reader asked me to help get her in contact with Danny Lara.

“My father-in-law died under similar circumstances at the VA in 2005,” she wrote in an e-mail.

I suppose it doesn’t look good for the VA to have this kind of information made public. But at least the VA has a transparent, open process for addressing problems. When the OIG investigates a VA hospital, a report is typically written and filed on the Internet for all to see. I doubt that private hospitals are subject to that degree of public scrutiny, even when they’re investigated by medical industry groups such as The Joint Commission.

There have been lawsuits filed and damages awarded for reported cases of “fluid overload” at U.S. hospitals outside Texas. The science of fluid management has even extended to the sports world and combat zones, since some athletes and foreign troops have reportedly died from hyponatremia, or “water intoxication,” caused by a loss of sodium in the blood. Marathon runners who used to live by the mantra of drinking as much water as they could have learned to just let their thirst be their guide.

You might have read or seen reports of people who have died from water intoxication during college hazing rituals, including one student who died in New York in 2003 and another in California in 2005. Last year, a woman died from water intoxication after participating in an on-air water-drinking contest at a Sacramento radio station.

But when it comes to managing fluid after surgery, patients and their families have to rely on doctors and other hospital staff to do what’s best.

One reader wrote that Sunday’s article “struck a chord with me and my family,” since her mother died last June at a private hospital in San Antonio, two days after open heart surgery. As with the Laras, the woman’s family was told that use of diuretics, to relieve fluid pressure by increasing urine production, would cause her blood pressure to drop.

“They gave her so many fluids that we didn’t even recognize her and the funeral director recommended a closed casket,” wrote the patient’s daughter, who also wanted to get in touch with Danny Lara.

Like the Laras, this woman’s family couldn’t find a lawyer to take on a malpractice case, since non-economic damages are capped at $250,000 in Texas. Unless a deceased patient was a high-paid executive or other person of means, entitled to economic damages due to loss of income, a case isn’t going to generate enough in damages for a lawyer to want to pursue a costly malpractice lawsuit.

That underscores one of the reasons for doing the story, to bring to light the issue of fluid management in hospitals, since improvements in care through the state’s legal system don’t appear likely. There seems to be some disagreement in the medical community on fluid management. Perhaps what’s needed most is more research and better training on use of fluids and diuretics.

Sunday’s article also addressed systemic issues related to the way doctors and nurses exchange information at Audie Murphy and interact with family members — and hopefully work together in the patient’s best interest.

As a result of the VA report, use of medical fluid in hospitals is an issue more people are talking and thinking about. Hopefully, some good will come of it.